KENNETH C KIM DO Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125075992

License Status

CANCELLED

Business

Title

First Name

KENNETH

Middle

Last Name

KIM

Business Name

KENNETH C KIM DO

Original Issue Date

06/26/2020

Effective Date

06/26/2020

Expiration Date

06/25/2023

City

SPRINGFIELD

State

Zip

62707

County

SANGAMON

Specialty/Qualifier

Diagnostic Radiology

Ever Disciplined

LastModifiedDate

04/30/2020